Occupational safety and health management systems (SHMS) are different from typical S&H programs in that they are more proactive and integrated by incorporating elements of evaluation and continuous improvement [9]. An SHMS also holds everyone accountable and responsible within an organization [10]. There can be many variations to an SHMS, based on company size, tenure, and current challenges and goals. Commonly used frameworks include OHSAS 18001, ANSI Z-10, the Occupational Safety and Health Administration’s (OSHA) Voluntary Protection Program (VPP), and CORESafety, developed specifically for mining by the National Mining Association (NMA).

These frameworks share common features, including change management. For example, CORESafety discusses the importance of working with equipment manufacturers during product development, working with management to mitigate any deviations from standard practice, and incorporating already-established safety and health requirements to prevent incidents [11]. The ANSI Z-10 manual also focuses on management of change, defined as: The process to identify and manage changes to minimize the introduction of new hazards and risks into the work environment [12]. Examples include changes in technology, equipment, facilities, work practices and procedures, design specifications, raw materials, organizational staffing changes, and standards or regulations [11].

One part of effective change management is the determination of interventions and practices that can be used by organizations to integrate technology; however, this topic has received little attention in the literature [13]. There are a few reasons that this gap exists. First, systematic literature reviews argue that research to date has resulted in a lack of actionable data that is needed to understand internal and external influencers [14]. Second, there has been a lack of concerted efforts toward theoretically informed research in this area [5,14,15]. Finally, technology acceptance research has lacked a longitudinal dimension although more current research is promising in advancing this area [16,17]. This research aimed to address these gaps using CPDMs as the technology of interest.

Recent data suggests that after a consistent decline in coal workers’ pneumoconiosis (CWP) or “black lung disease,” the prevalence of new cases is increasing. For example, a recent NIOSH study found that 2% of examined surface coal mineworkers—most of whom had never worked in underground mines—had some degree of CWP [18]. In addition, there has been a sharp increase in progressive massive fibrosis (PMF), a more serious form of CWP, among young mineworkers in the Appalachian region [19].

Prior to this newfound data, the Mine Safety and Health Administration [MSHA] passed a multi-phase law on May 1, 2014, titled Lowering Mineworkers’ Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors (30 CFR Parts 70, 71, 72, 75, and 90) [20]. Under the new law, the dust level may not exceed 1.5 mg/m³ (previously 2 mg/m³ for any work shift). Another phase of the regulation required mine operators to start using a continuous personal dust monitor by February 1, 2016, for designated occupations (DO) and other designated occupations (ODOs) to monitor and comply with regulatory exposures. As defined in the new rule, the DO is the occupation on a mechanized mining unit (MMU) that has been determined by results of respirable dust samples to have the greatest respirable dust concentration [20]. The ODO is another occupation on an MMU that is also designated for sampling. Underground coal mines are required to use the CPDM to collect 15 valid sampling shifts each for the DO and ODO per quarter per MMU, all while complying with this lower standard. The DO and ODO cannot be sampled concurrently, so a minimum of 30 shifts of sampling must be conducted on each MMU. If blowing face ventilation is used, the face haulage operator (e.g., shuttle car operator) must also be sampled as another ODO, so a minimum of 45 sampling shifts must be completed for these MMUs. Table 1 shows the primary DOs and ODOs who are defined in the new rule for continuous mineworker MMUs and are required to the wear the CPDM.

Although CPDMs provide mineworkers with near real-time feedback about their level of respirable coal dust exposure through dust data output that is updated every 30 min, they do not ensure that workers or the organization will continuously use the information to learn about and reduce exposure sources. Training-related interventions on technology acceptance are more often the norm, but there is little research on how to best integrate the technology within the organizational system and its respective processes [22]. Therefore, upon understanding how coal mineworkers interpreted their dust exposure data, rather than train on this information, researchers sought to analyze workers’ individual perceptions and work practices to help holistically integrate this technology with the organizational workforce.

As Table 2 shows, the regulations in other countries vary from the United States with almost all countries having a higher regulatory limit (all dependent upon silica content at each mine). However, more recently other countries, such as Australia, have placed an added emphasis on reducing workers’ exposure to respirable dust and as a result, the findings in the current study can translate to how all organizations can respond to dust data and work together to mitigate exposures.

This study design incorporated self-determination theory (SDT) [24]. SDT has three assumptions, including that individuals: (1) are proactive; (2) are naturally prone toward growth and improvement; and (3) have psychological needs that are innate, universal, and essential for health maintenance [25]. In addition, SDT posits that there are two types of motivation that influence health-related behaviors: intrinsic (or autonomous) and extrinsic (or controlled) [26]. Both intrinsic and external motivations have been shown to directly impact the use or misuse of technology [27,28].

When individuals are intrinsically motivated, they will likely complete an activity if they find it to be helpful, interesting, or personally enjoyable [29]. Alternatively, if an individual is extrinsically motivated, then more often an activity is completed to receive external rewards. Extrinsic motivation involves acting with some sense of pressure such as to gain approval from others, to avoid punishment, or feelings of guilt [24]. In other words, people are persuaded into action only when that action is instrumental to those ends (e.g., I work when my boss is watching) [26]. By this theory, extrinsically motivated actions are completed on an as-needed basis and are likely to persist only as long as the external contingency is present.

Previous research involving the CPDM found promise in stimulating workers’ self-protective behaviors to lower exposure to respirable dust [38]. Peters and colleagues found that, despite barriers related to the design of the CPDM, some participating mineworkers were able to decrease their exposure to respirable dust [38]. In addition, others who did not have a good frame of reference for interpreting their numbers could still base their actions on whether the numbers were going up or down. The ultimate goal, however, is to have an informed workforce within a proactive organization that can take advantage of the CPDM’s capabilities. Therefore, this intervention used SDT to identify intrinsic and extrinsic needs of using CPDMs to preserve workers’ health and subsequently, identify ways to help organizations manage technological change. In response, the following research questions were considered:

Why do (or don’t) coal mineworkers use their CPDMs to identify and engage in dust-reducing work practices?

NIOSH obtained Institutional Review Board (IRB) and Office of Management and Budget (OMB) approval to visit three mines on two separate occasions during 2016 and 2017 to talk with mineworkers and members of management. Two of the mines were considered average seam height and one was considered low-coal [39]. The mines were located in West Virginia and Virginia. The study recruited 35 rank-and-file mineworkers who have worn and responded to the dust data provided via the CPDM.

The 35 mineworkers completed a survey and participated in an interview or focus group during the first visit. The discussions allowed mineworkers to share their experiences with the CPDM. Each of the participating workers was currently or had just finished a sampling period using the CPDM, or would be sampling in the near future. This allowed NIOSH researchers to debrief their personal dust data cards with workers or a dust data card that was the same DO or ODO. During these dust data card debriefs, workers shared repeated situations in which respirable dust was higher, thoughts on sources of higher exposure, and then actions they could to reduce exposure. In addition, workers also shared what actions, if any, had been maintained over time to sustain a lower exposure. There were usually 3–4 workers from a crew present for the focus groups. Of the 35 underground coal mineworkers, all were male and 37% (n = 13) were continuous mining machine operators; 37% (n = 13) were shuttle car operators; and 26% (n = 9) were roof bolters.

In addition, 15 members of mine management discussed current interventions at their respective sites in response to the CPDM dust data output. They shared ways that they help support dust control practices on site and how they communicate the CPDM dust data to their workforce. Due to confidentiality and compliance issues, the details on what each dust sample entailed during the study is not being debriefed. However, the general sources that workers identified as well as corrective actions to reduce exposure are more useful to both the domestic and international mining industry, thus, this is the information discussed throughout the paper.

Because individuals are more likely to initiate a change if they feel the choice is aligned with their values, it was important to develop a targeted, self-regulation questionnaire [30,32]. Self-regulation questionnaires assess domain-specific individual differences in the directive of a particular behavior (e.g., using a CPDM, wearing a respirator) or a class of behaviors (e.g., engaging in several behaviors to reduce dust exposure). A “Learning Self-Regulation Questionnaire” (SRQ-L) questionnaire was adapted from Williams and Deci as well as and Black and Deci to help researchers understand how and why mineworkers use the CPDM to learn about and reduce their respirable dust exposure [34,37].

The questionnaire measured the two SDT subscales—intrinsic and extrinsic motivation to take into account why coal mineworkers may decide to learn a specific behavior. The 13 survey items were retained but basic terminology was changed to reflect mineworkers’ use of the CPDM. The only change made to the original scale was the use of a 6-point Likert scale rather than a 7-point scale, so the participating mineworkers would have to select one side or the other in relation to “not true at all” and “very true.” Previous studies have rendered Cronbach’s alpha reliabilities of approximately 0.75 for controlled and 0.80 for autonomous [37]. The current study rendered similar results with the alpha for extrinsic regulation (7 items) being 0.85 and the alpha for intrinsic regulation (6 items) being 0.77.

Follow-up visits occurred approximately 8 weeks later at each site in order to reevaluate if any new dust sources had been identified via the CPDM or any new dust controls were put in place. Participants discussed any maintained changes in response to the CPDM dust data output. The same mineworkers were asked if they continued using information gleaned from the CPDM to sustain protective work practices, even when they did not have to wear the technology to comply with the regulation. Individual responses were linked to workers’ surveys. Two of the workers were not available at the follow-up visit to provide a yes/no response to this question. Fig. 1 shows a flowchart of the intervention process.

The surveys were entered into SPSS and coded for future analysis. For the purposes of this paper and the smaller sample size, only averages are reported for the survey constructs in addition to one correlation analysis. The interview data was analyzed and coded in a series of stages. Initial coding of the data occurred while typing the interview and focus group notes. Then, more focused efforts took place to identify codes under the respective theoretical constructs of SDT –autonomy, competence, and relatedness [30,40,41]. This allowed a better understanding of what influenced workers to engage in certain dust-protective behaviors and maintain those behaviors. Themes that continually emerged under each of the three theoretical codes are reported in the results section.

After adding the seven controlled regulation survey items and averaging them, the mean was 3.27 (on a 6-point scale from “not true at all” to “very true”). Using the same process for the six-item autonomous regulation scale, the average among participants was 4.29. This approximately 1-point difference between the two scale averages illustrates first, that mineworkers are more intrinsically rather than extrinsically motivated to use and respond to the CPDM dust data to protect their health and second, that extrinsic motivation does not play a large role in mineworkers’ health decisions related to dust exposure on the job, considering the “not true” average being below a 4.0. Results for each item are listed in Tables 3 and 4.

Even with the small sample size, much can be gleaned from looking at the responses to the survey items. For example, mineworkers trended toward “true” responses to items that asked if the CPDM is a good way to try to improve their health and its utility in identifying main sources of respirable dust. Alternatively, for the controlled items, it is apparent that mineworkers do not necessarily value what others think of them in terms of motivating a health-related action. This is evident in the 2.66 average (not true), “Others would think badly of me if I didn’t [use my CPDM].”

The survey results showed little difference in averages among the DO/ODO groups (see Table 5). Due to the small sample, statistical significance cannot be determined among the three groups. However, we can still learn something from these averages regarding all DOs and ODOs being more influenced through intrinsic means rather than extrinsic factors.

As mentioned earlier, each mineworker was asked during the follow-up visit if he continued to act upon information he learned through the CPDM, whether he was wearing the technology or not. Of the 33 responses (2 were not present on our follow-up visits), 21 workers (64%) said “yes” and 12 workers (36%) said “no.” A chi-square for independence was completed to identify if there was any association between workers who were either more autonomously motivated or externally motivated and workers’ continued application of dust-reducing practices learned through the CPDM. The chi-square test for independence (reporting Fisher’s Exact Test) indicated a significant association between a workers’ motivation and continuous dust-reducing behaviors, χ² (1, n = 30) = 0.00, p = 0.00, Cramer’s V = 0.850. Fig. 2 shows the breakdown of responses. Fisher’s Exact Test is reported instead of Yates Continuity Correction because 1 cell (25%) had a count less than 5, which violated minimum expected cell frequency.

In summary, the survey results indicate that using the CPDM to identify and reduce sources of dust exposure is consistent with mineworkers’ self-values to protect their health and not necessarily because of compliance to a supervisor or mine. This result provides insight into the organization catering toward mineworkers’ intrinsic values rather than focusing on extrinsic rewards or consequences. The qualitative data analysis below sheds more insight into this topic.

The qualitative data collected illustrated reasons why using the CPDM stemmed more from intrinsic rather than extrinsic motivation. Specifically, when participants were asked to discuss how they have used the CPDM, their perception of the technology, and the impact it has had on their work processes and practices, virtually all of the responses focused on the newfound control mineworkers had in identifying and mitigating their risks (i.e. increasing personal autonomy). Specifically, all 35 workers referenced at least one thing that they did not know about their dust exposure sources or levels, prior to wearing the CPDM. Most mineworkers expressed that they often look at their CPDM output to see what they might be able to learn and that they are still learning, even after wearing the CPDM multiple times. For example, one mineworker said, “I always like looking at my readout. It’s nice to see what the feedback was so you can prevent exposure later … if I know where or when I got a spike last time, and if that means I can stand in a different spot or something.” Most mineworkers indicated that they look at their output and ask questions about their exposure to their fellow coworkers or direct managers. Several also stated that they cannot deny that they work in a dusty environment but over time, this technology helps deal with that. Table 6 illustrates a variety of abridged comments to highlight some of the discussions with workers.

Due to an enhanced sense of control and efficacy, many mineworkers reported increased learning about their exposures and mitigation strategies. Specific corrective actions that mineworkers learned are outlined elsewhere [42]. However, continuous mining machine operators often reported four scenarios that most often impacted their dust exposure and five corrective actions in response to this exposure including changing one’s position while completing a specific task; being more aware of dust that is respirable; avoiding walking through certain areas of dust clouds; and creating and sustaining new habits based on their dust data feedback. Similarly, roof bolters identified three common scenarios that exposed them to more respirable coal dust and five corrective actions [42].

Finally, responses during focus groups revealed a sense of relatedness among the work crews. Specifically, 19 of the 35 participants (54%) mentioned learning and informing each other about dust hazards, which they indicated happened on a minimal level prior to using the CPDM [43]. In general, mineworkers said that they try to help each other more, especially during shift changes, to prevent out-of-compliance samples. One mineworker said, “We all look at each other’s cards or talk about our readings. Everyone in the mine is more aware of each other’s behaviors and how it can affect each other underground.” In addition, mineworkers discussed holding each other accountable to communicate when their specific DO or ODO was wearing the CPDM. For example, one roof bolter said, “Whoever is wearing it [the CPDM] at the time, it’s their responsibility to tell us what’s going on down there.”

Although mineworkers discussed an enhanced awareness and communication among their work crews, their end goal was to stay in compliance while wearing the CPDM rather than adhering to any sort of internal or external value. Related to external motivations, however, the dust regulation in place provided no choice but to try to comply with new standards. To illustrate, throughout the interview notes for the 35 participating workers, references to compliance, fear of being overexposed or out of compliance, and being distracted because they are worried about exposure levels, was referenced 42 times. This means that several workers mentioned their fear of being out of compliance more than once throughout the interview or focus group, showing how prominent this topic was on their sites. Specifically, supervisors’ communication with the workers followed a similar tone related to compliance. However, most supervisors referenced that the CPDM caused initial distractions because workers were afraid to be out of compliance. Although most mineworkers had no complaints about their organizational and supervisor support for dust control resources, they also had little to report about communicative support and information from their management.

To illustrate, when asked what he knew about the CPDM, one worker said, “We weren’t really told anything, just that we were going to have to wear it.” There was consistent feedback from workers about minimal planning, communication, and coordination on behalf of organizational management about this upcoming change. Upon using the technology, these same workers expressed minimal communication and feedback about their dust data cards. In addition, some workers were disappointed in the lack of a coordinated response plan to maintain low exposures. These results show multiple intervention points for a stronger technology integration and response process that also leverages workers’ intrinsic health values.

A primary takeaway from this study is the understanding of workers’ main motivations for utilizing their CPDMs, which are intrinsic. A similar finding was revealed relative to occupational inspectors on worksites, whose use of autonomous communication with workers resulted in fewer compliance orders [45]. This study shows similar promise in that, through a better understanding of the intrinsic motivations toward using the CPDM, not only can quicker technology implementation and integration occur at mine sites, but a possibility also exists for sustained reductions in exposure to respirable silica dust. Therefore, during any technology integration and related planning, it would behoove managers to use autonomy supportive tactics with mineworkers to understand primary motivations for making both health and compliance-related decisions on the job. In response, it may be easier to develop more targeted interventions that seek to elicit these internal motivations. One method is to apply participatory ergonomics, which actively involves workers in developing and implementing workplace changes to reduce safety risks [46,47]. In other words, fitting a technology integration intervention with the needs of workers and the organization through a constant feedback loop during implementation may help facilitate workers’ motivation to participate in a new safety activity or adopt a technology [48].

Interdependent with this consideration is the value of using managerial interventions as a powerful tool for organization-wide technology adoption [22]. The data revealed specific content that can be included in such interventions that come from management. Such tactics should include both transformative and transactional leadership styles to include rational discussions with workers about their exposure to respirable dust; involvement in decision making to improve engineering controls and work practices; and generating a sense of enthusiasm that workers have this newfound “control” to protect their health on the job. Examples of potential intervention points to address these areas are discussed below [49].